Individual
JEREMY TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12109
MN
2251X0800X
Orthopedic Physical Therapist
1309532
TX
Other
Enumeration date
10/06/2020
Last updated
12/15/2020
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